Efficacy and Safety of Oral Paracetamol vs. Oral Ibuprofen in the Treatment of Symptomatic Patent Ductus Arteriosus in Premature Infants
ConclusionsOur results indicate that oral paracetamol was as effective as oral ibuprofen in the medical treatment of PDA. In addition, both drugs were considered well-tolerated in terms of effects on kidney, liver, and intestinal functions. Our results demonstrate that oral paracetamol can be used effectively and safely as the first-line treatment of PDA. (Source: Pediatric Drugs)
Source: Pediatric Drugs - April 26, 2019 Category: Pediatrics Source Type: research

Current and Emerging Therapeutic Options for the Management of Rare Skeletal Diseases
AbstractIncreasing knowledge in the field of rare diseases has led to new therapeutic approaches in the last decade. Treatment strategies have been developed after elucidation of the underlying genetic alterations and pathophysiology of certain diseases (e.g., in osteogenesis imperfecta, achondroplasia, hypophosphatemic rickets, hypophosphatasia and fibrodysplasia ossificans progressiva). Most of the drugs developed are specifically designed agents interacting with the disease-specific cascade of enzymes and proteins involved. While some are approved (asfotase alfa, burosumab), others are currently being investigated in ph...
Source: Pediatric Drugs - April 3, 2019 Category: Pediatrics Source Type: research

Medical Options for the Adjuvant Treatment and Management of Pediatric Melanoma
AbstractAlthough melanoma is a rare diagnosis in the pediatric population, advances in the management of adults with melanoma offer the prospect of promising therapeutic options for children. At this time, medical management is not considered curative but may reduce the risk of recurrence or prolong survival. Surgical management remains the mainstay of treatment. Medical therapy of pediatric melanoma is not thought to have a role for in situ, early-stage, or localized disease, but adjuvant therapy may have a role in improving the prognosis of patients with positive sentinel lymph node biopsy (SLNB), spread beyond the regio...
Source: Pediatric Drugs - March 28, 2019 Category: Pediatrics Source Type: research

Vancomycin Prescribing and Therapeutic Drug Monitoring in Children With and Without Acute Kidney Injury After Cardiac Arrest
ConclusionsIn children with AKI after cardiac arrest, decreased vancomycin clearance was evident early, and early monitoring was not performed universally in those with low initial eGFR. Earlier vancomycin therapeutic drug monitoring is indicated in this high-risk population. (Source: Pediatric Drugs)
Source: Pediatric Drugs - March 12, 2019 Category: Pediatrics Source Type: research

Neuropathic Pain in Pediatric Oncology: A Clinical Decision Algorithm
AbstractNeuropathic pain in pediatric oncology can be caused by distinct lesions or disease processes affecting the somatosensory system, including chemotherapy-related neuronal injury, solid tumor-related involvement of neural structures, post-surgical neuropathic pain —including phantom limb pain and pain after limb-sparing surgery—and the complex circumstances of neuropathic pain at the end of life. Treatment algorithms reflect the general treatment principles applied for adult neuropathic pain, but the dose regimens applied in children are modest and rarely escalated to the maximum doses to optimize analges...
Source: Pediatric Drugs - February 14, 2019 Category: Pediatrics Source Type: research

A Practical Guide to Treatment of Childhood Absence Epilepsy
AbstractChildhood absence epilepsy (CAE) is a common pediatric epilepsy syndrome with distinct seizure semiology, electroencephalography (EEG) features, and treatment. A diagnosis of CAE can be obtained during an office visit with a careful history, physical exam including prolonged hyperventilation, and a routine EEG. The treatment of choice for CAE with absence seizures only is ethosuximide. Valproic acid and lamotrigine are also effective treatments for many patients, but when compared to ethosuximide, valproic acid has more adverse effects and lamotrigine is less effective. Attention to predictors of response to treatm...
Source: Pediatric Drugs - February 8, 2019 Category: Pediatrics Source Type: research

Pharmacotherapeutic Management of Wilms Tumor: An Update
AbstractAlthough differences exist in treatment and risk-stratification strategies for children with Wilms tumor (WT) between the European [International Society of Paediatric Oncology (SIOP)] and American [Children ’s Oncology Group (COG)] study groups, outcomes are very similar, with an overall survival of>  85%. Future strategies aim to de-intensify treatment and reduce toxicity for children with a low risk of relapse and intensify treatment for children with high-risk disease. For metastatic WT, response of lung nodules to chemotherapy is used as a marker to modify treatment intensity. For recurren t WT...
Source: Pediatric Drugs - January 2, 2019 Category: Pediatrics Source Type: research

Pancreatic Enzyme Supplementation in Patients with Atopic Dermatitis and Food Allergies: An Open-Label Pilot Study
AbstractBackgroundAtopic dermatitis (AD) is a chronic inflammatory skin disease that affects both patients and their families. Current therapies often alleviate symptoms but do not prevent or eradicate the disease.ObjectivesOur objective was to determine whether pancreatic enzyme supplementation is an effective and safe treatment in refractory pediatric AD associated with food allergies.MethodsWe conducted an open-label pilot study using a case –control design. Patients with severe AD and known food allergies refractory to conventional therapies and exclusion diets were recruited and treated for 6 weeks with ora...
Source: Pediatric Drugs - December 17, 2018 Category: Pediatrics Source Type: research

Clinical Features and Treatment of Down Syndrome Arthropathy: Experience from Two US Tertiary Hospitals
AbstractBackgroundArthropathy of Down syndrome (DA) is largely under-recognized, with an average 2-year delay in diagnosis. Most patients present with polyarthritis, and treatment has historically been challenging.ObjectivesOur objective was to investigate the clinical features and treatment of DA in the largest cohort reported to date.MethodsIn a retrospective chart review at two tertiary care hospitals,International Classification of Diseases, ninth revision,clinical modification (ICD-9-CM) codes for Down syndrome (DS) and juvenile idiopathic arthritis (JIA), between 1 January 1995 and 31 December 2015, were identified a...
Source: Pediatric Drugs - December 13, 2018 Category: Pediatrics Source Type: research

Serious Adverse Events Associated with Off-Label Use of Azithromycin or Fentanyl in Children in Intensive Care Units: A Retrospective Chart Review
ConclusionsAzithromycin off-label use in pediatric ICUs does not appear to be associated with an increased risk of SAEs. Off-label use of fentanyl appears to be more frequently associated with respiratory depression when used off-label by both age and indication in pediatric ICUs. Prospective studies should be undertaken to assess the safety and efficacy of fentanyl in the pediatric population so that data can be added to the FDA labeling. (Source: Pediatric Drugs)
Source: Pediatric Drugs - November 28, 2018 Category: Pediatrics Source Type: research

Topical Pharyngeal Lidocaine Reduces Respiratory Adverse Events During Upper Gastrointestinal Endoscopies Under Ketamine Sedation in Children
AbstractBackgroundUpper gastrointestinal endoscopies (UGEs) performed under ketamine sedation may increase the risk of respiratory adverse events (RAEs) due to pharyngeal stimulation. Topical lidocaine prevents general anesthesia-induced laryngospasm.ObjectiveOur objective was to determine whether topical lidocaine may reduce the incidence of RAEs induced by pharyngeal stimulation in UGEs performed on children sedated with ketamine.MethodsWe conducted a single-center prospective study. We included every patient admitted for an elective diagnostic UGE under ketamine sedation who received lidocaine prior to the technique. Pa...
Source: Pediatric Drugs - November 27, 2018 Category: Pediatrics Source Type: research

Dasatinib: A Review in Pediatric Chronic Myeloid Leukemia
AbstractChronic myeloid leukemia (CML) is a rare hematopoietic stem cell disease that is typically characterized by the abnormalBCR-ABL1 fusion gene on the Philadelphia (Ph) chromosome in neoplastic cells. Dasatinib (Sprycel®) is an orally administered, small molecule tyrosine kinase inhibitor indicated for the treatment of certain hematological malignancies, including Ph-positive CML in the chronic phase (Ph+ CML-CP) in adult and pediatric patients. In open-label phase 1 and phase 2 clinical trials, dasatinib produced early and durable target responses (i.e. molecular, cytogenetic and/or hematologic) in pediatric pati...
Source: Pediatric Drugs - November 22, 2018 Category: Pediatrics Source Type: research

Acknowledgement to Referees
(Source: Pediatric Drugs)
Source: Pediatric Drugs - November 13, 2018 Category: Pediatrics Source Type: research

Changes in Hemoglobin Concentrations Post-immunoglobulin Therapy in Patients with Kawasaki Disease: A Population-Based Study Using a Claims Database in Japan
ConclusionsAlthough mild anemia commonly occurred post-IVIG therapy in Japanese individuals with KD, severe anemia necessitating transfusion was rare in these patients. (Source: Pediatric Drugs)
Source: Pediatric Drugs - October 22, 2018 Category: Pediatrics Source Type: research

Potentiators and Correctors in Paediatric Cystic Fibrosis Patients: A Narrative Review
AbstractCystic fibrosis is the most common inherited condition in the Caucasian population and is associated with significantly reduced life expectancy. Recent advances in treatment have focussed on addressing the underlying cause of the condition, the defective production, expression and function of the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Several drugs with different modes of action have produced promising results in clinical trials, and some have been incorporated into routine clinical care for specific patients in many countries worldwide. Further trials continue to explore the safety and...
Source: Pediatric Drugs - October 17, 2018 Category: Pediatrics Source Type: research

Pharmacotherapy for Persistent Posttraumatic Headaches in Children and Adolescents: A Brief Review of the Literature
AbstractConcussion, now most often referred to as mild traumatic brain injury in recent literature, is common in pediatrics, and headache is often the most common complaint post-injury. Although most children and adolescents recover within 1 –2 weeks, some develop frequent and debilitating headaches that can last for months or longer. Most clinicians would agree on the importance of managing both acute and persistent posttraumatic headaches appropriately to speed recovery, minimize disability, maximize function, and improve quality o f life, but there are no well-established guidelines to instruct physicians in ...
Source: Pediatric Drugs - October 1, 2018 Category: Pediatrics Source Type: research

Trends in Outpatient Prescription Medicine Use in New Zealand Children 2010 –2015: A National Population-Based Study
AbstractBackgroundResearch examining trends in the outpatient prescription medicine use of New Zealand children is limited.ObjectivesOur objective was to provide an overview of prescription medicine use in New Zealand children and assess changing patterns in use from 2010 to 2015.MethodsWe conducted a retrospective cohort study including all New Zealand primary care-registered children aged
Source: Pediatric Drugs - October 1, 2018 Category: Pediatrics Source Type: research

Current Challenges in Neonatal Resuscitation: What is the Role of Adrenaline?
AbstractAdrenaline, also known as epinephrine, is a hormone, neurotransmitter, and medication. It is the best established drug in neonatal resuscitation, but only weak evidence supports current recommendations for its use. Furthermore, the available evidence is partly based on extrapolations from adult studies, and this introduces further uncertainty, especially when considering the unique physiological characteristics of newly born infants. The timing, dose, and route of administration of adrenaline are still debated, even though this medication has been used in neonatal resuscitation for a long time. According to the mos...
Source: Pediatric Drugs - October 1, 2018 Category: Pediatrics Source Type: research

Pediatric Cancer Immunotherapy: Opportunities and Challenges
AbstractCancer immunotherapies, widely heralded as transformational for many adult cancer patients, are becoming viable options for selected subsets of pediatric cancer patients. Many therapies are currently being investigated, from immunomodulatory agents to adoptive cell therapy, bispecific T-cell engagers, oncolytic virotherapy, and checkpoint inhibition. One of the most exciting immunotherapies recently FDA approved is the use of CD19 chimeric antigen receptor T cells for pre-B-cell acute lymphoblastic leukemia. With this approval and others, immunotherapy for pediatric cancers is gaining traction. One of the caveats t...
Source: Pediatric Drugs - October 1, 2018 Category: Pediatrics Source Type: research

A Population-Based Pharmacokinetic Model Approach to Pantoprazole Dosing for Obese Children and Adolescents
ConclusionsOur data argue against empiric dose escalation of PPIs for obese children and support current FDA-approved pediatric weight-tiered dosing for pantoprazole; however, 3- to 5-fold inter-individual variability in pantoprazole AUC0 –∞ remained using this dosing approach. (Source: Pediatric Drugs)
Source: Pediatric Drugs - October 1, 2018 Category: Pediatrics Source Type: research

Prevention and Management of Bleeding Episodes in Children with Hemophilia
AbstractRegular prophylactic treatment with factor VIII (FVIII) and factor IX (FIX) concentrates in hemophilia A and B, respectively, is introduced in early infancy and has resulted in dramatic improvement of the conditions. Recombinant FVIII and FIX concentrates have been available for  >  25 years and have been modified and refined through the years; however, unfortunately frequent intravenous administrations are still necessary. The half-lives of these products have now been extended (EHL) by fusion with albumin, the Fc-portion of IgG, or by being PEGylated. This has been very s uccessful for EHL-F...
Source: Pediatric Drugs - October 1, 2018 Category: Pediatrics Source Type: research

Pharmacokinetics and Drug Interaction of Antiepileptic Drugs in Children and Adolescents
AbstractSelecting the most appropriate antiepileptic drug (AED) or combination of drugs for each patient and identifying the most suitable therapeutic regimen for their needs is increasingly challenging, especially among pediatric populations. In fact, the pharmacokinetics of several drugs vary widely in children with epilepsy because of age-related factors, which can influence the absorption, distribution, metabolism, and elimination of the pharmacological agent. In addition, individual factors, such as seizure type, associated comorbidities, individual pharmacokinetics, and potential drug interactions, may contribute to ...
Source: Pediatric Drugs - October 1, 2018 Category: Pediatrics Source Type: research

Methadone for Pain Management in Children with Cancer
AbstractMethadone is a synthetic opioid with unique pharmacodynamic and pharmacokinetic properties. It is effective in treating both nociceptive and neuropathic pain, which commonly co-exist in children with cancer. Upon reviewing the literature describing the use of methadone in pediatric oncology patients, publications are limited in number and low in quality of evidence; nevertheless, there is support for the safety and efficacy of methadone in treating pain in children with cancer, particularly when pain is refractory to conventional treatment. Although the risk of life-threatening arrhythmia is commonly cited as an ar...
Source: Pediatric Drugs - October 1, 2018 Category: Pediatrics Source Type: research

Efficacy and Safety of Intravenous Colistin in Very Low Birth Weight Preterm Infants
This study aims to assess the efficacy and safety of intravenous colistin in very low birth weight (VLBW; birth weight  0.99). Serum magnesium and potassium levels were significantly lower in the VLBW group than in the non-VLBW group during colistin therapy (magnesium, 1.30 vs 1.70 mg/dL,p 
Source: Pediatric Drugs - October 1, 2018 Category: Pediatrics Source Type: research

Diversified Pediatric Pharmacoepidemiology: An International Priority
(Source: Pediatric Drugs)
Source: Pediatric Drugs - October 1, 2018 Category: Pediatrics Source Type: research

Optimizing the Use of Medications and Other Therapies in Infant Gastroesophageal Reflux
AbstractGastroesophageal reflux (GER) is the retrograde movement of gastric (and sometimes duodenal) contents into the esophagus. While the majority of GER is physiologic, for patients, it can be associated with symptoms. While some symptoms are merely bothersome (crying), others can be life threatening (cough, gagging, choking). The main driver of GER in infants is the frequent feedings that produce increased intra-abdominal pressure, which is known to trigger transient relaxations of the lower esophageal sphincter. The recent 2018 clinical practice guidelines reported by the North American and European Societies for Pedi...
Source: Pediatric Drugs - September 10, 2018 Category: Pediatrics Source Type: research

An Update in Antimicrobial Therapies and Infection Prevention in Pediatric Lung Transplant Recipients
AbstractLung transplantation can offer life-prolonging therapy to children with otherwise terminal end-stage lung disease. However, infectious complications, like those experienced by their adult counterparts, are a significant cause of morbidity and mortality. These include bacteria, viruses, and fungi that infect the patient pretransplant and those that may be acquired from the donor or by the recipient in the months to years posttransplant. An understanding of the approach to the management of each potential infecting organism is required to ensure optimal outcomes. In particular, emphasis on aggressive preoperative man...
Source: Pediatric Drugs - September 6, 2018 Category: Pediatrics Source Type: research

The Effect of Alginate in Gastroesophageal Reflux in Infants
AbstractBackgroundGuidelines are contradictory regarding the use of alginate in infants with persisting gastroesophageal reflux (GER). While The British National Institute for Health and Care (NICE) guidelines consider alginate as a treatment option, the guidelines of the European and North-American Societies for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN, NASPGHAN) do not recommend alginates.AimsWe assessed the efficacy of alginate to reduce GER episodes in infants.MethodsIn a prospective, observational study, we consecutively enrolled all infants referred for pH-multiple intraluminal impedance (pH-MII)...
Source: Pediatric Drugs - September 4, 2018 Category: Pediatrics Source Type: research

Pharmacological Approach to Managing Childhood-Onset Systemic Lupus Erythematosus During Conception, Pregnancy and Breastfeeding
AbstractPediatric patients often have poor pregnancy outcomes. Systemic lupus erythematosus predominantly impacts women in their second to fourth decade of life, with childhood-onset disease being particularly aggressive. Reproductive issues are an important clinical consideration for pediatric patients with systemic lupus erythematosus (SLE), as maintaining good disease control and planning a pregnancy are important for maternal and fetal outcomes. In this clinical review, we will consider the safety of medications in managing childhood-onset SLE during conception, pregnancy, and breastfeeding. The developing fetus is at ...
Source: Pediatric Drugs - September 3, 2018 Category: Pediatrics Source Type: research

Diversified Pediatric Pharmacoepidemiology: An International Priority
(Source: Pediatric Drugs)
Source: Pediatric Drugs - August 23, 2018 Category: Pediatrics Source Type: research

Sexually Transmitted Infections in Pregnant Women: Integrating Screening and Treatment into Prenatal Care
AbstractChlamydia, gonorrhea, and syphilis continue to be significant burdens to the health of pregnant women and their children despite easy and effective guidance for screening and treatment. Specific guidelines exist for screening for these infections as well as treatment and follow-up. In this article, we review the epidemiology of chlamydia, gonorrhea, and syphilis. Testing methodology is also reviewed as molecular-based techniques have replaced culture as the current gold standard tests of choice for chlamydia and gonorrhea. The nontreponemal and treponemal serologic diagnostic and screening approach to syphilis has ...
Source: Pediatric Drugs - August 21, 2018 Category: Pediatrics Source Type: research

Prevention and Management of Bleeding Episodes in Children with Hemophilia
AbstractRegular prophylactic treatment with factor VIII (FVIII) and factor IX (FIX) concentrates in hemophilia A and B, respectively, is introduced in early infancy and has resulted in dramatic improvement of the conditions. Recombinant FVIII and FIX concentrates have been available for  >  25 years and have been modified and refined through the years; however, unfortunately frequent intravenous administrations are still necessary. The half-lives of these products have now been extended (EHL) by fusion with albumin, the Fc-portion of IgG, or by being PEGylated. This has been very s uccessful for EHL-F...
Source: Pediatric Drugs - August 21, 2018 Category: Pediatrics Source Type: research

A Population-Based Pharmacokinetic Model Approach to Pantoprazole Dosing for Obese Children and Adolescents
ConclusionsOur data argue against empiric dose escalation of PPIs for obese children and support current FDA-approved pediatric weight-tiered dosing for pantoprazole; however, 3- to 5-fold inter-individual variability in pantoprazole AUC0 –∞ remained using this dosing approach. (Source: Pediatric Drugs)
Source: Pediatric Drugs - August 11, 2018 Category: Pediatrics Source Type: research

The Challenges of Cortisol Replacement Therapy in Childhood: Observations from a Case Series of Children Treated with Modified-Release Hydrocortisone
AbstractBackgroundHydrocortisone is the preferred treatment for adrenal insufficiency in childhood. A small minority of children experience low cortisol concentrations and symptoms of cortisol insufficiency, poorly responsive to modifications in dosing. We speculated that treatment with modified-release hydrocortisone Plenadren® may be beneficial in these selected patients.ObjectiveThe aim of this article was to report cortisol profiles during treatment with standard formulation hydrocortisone and Plenadren, and growth and weight gain during treatment with Plenadren in selected children with adrenal insufficiency.Patie...
Source: Pediatric Drugs - August 7, 2018 Category: Pediatrics Source Type: research

Efficacy and Safety of Intravenous Colistin in Very Low Birth Weight Preterm Infants
This study aims to assess the efficacy and safety of intravenous colistin in very low birth weight (VLBW; birth weight  0.99). Serum magnesium and potassium levels were significantly lower in the VLBW group than in the non-VLBW group during colistin therapy (magnesium, 1.30 vs 1.70 mg/dL,p 
Source: Pediatric Drugs - August 3, 2018 Category: Pediatrics Source Type: research

The Use of Ommaya Reservoirs to Deliver Central Nervous System-Directed Chemotherapy in Childhood Acute Lymphoblastic Leukaemia
AbstractProphylactic eradication of central nervous system (CNS) leukaemia is the current standard of care in treating childhood acute lymphoblastic leukaemia (ALL). This is conventionally achieved through regular lumbar punctures with intrathecal injections of methotrexate into the cerebrospinal fluid (CSF). Ommaya reservoirs are subcutaneous implantable devices that provide a secure route of drug delivery into the CSF via an intraventricular catheter. They are an important alternative in cases where intrathecal injection via lumbar puncture is difficult. Among UK Paediatric Principal Treatment Centres for ALL we found co...
Source: Pediatric Drugs - August 1, 2018 Category: Pediatrics Source Type: research

Nonalcoholic Fatty Liver Disease in Children: Not a Small Matter
AbstractThe prevalence of nonalcoholic fatty liver disease (NAFLD) has increased substantially in the past two decades and NAFLD has now become the most common cause of chronic liver disease in children and adolescents. NAFLD is a broad clinicopathologic spectrum ranging from simple steatosis to varying degrees of necroinflammation called nonalcoholic steatohepatitis (NASH), leading to fibrosis and subsequently to cirrhosis. Despite the increasing prevalence and progressive nature of NAFLD even among children, therapy for NAFLD in both adults and children are limited. Weight loss remains the only consistently effective the...
Source: Pediatric Drugs - August 1, 2018 Category: Pediatrics Source Type: research

Vancomycin in Pediatric Patients with Solid or Hematological Malignant Disease: Predictive Performance of a Population Pharmacokinetic Model and New Optimized Dosing Regimens
ConclusionThe model previously proposed by Guilhaumou et al. in pediatric patients with solid or hematological malignant disease was externally validated. Simulations have enabled the description of new dosage schedules and creation of a chart to help clinicians adapt vancomycin dosage. (Source: Pediatric Drugs)
Source: Pediatric Drugs - August 1, 2018 Category: Pediatrics Source Type: research

Dose-Dependent Teratology in Humans: Clinical Implications for Prevention
AbstractSince the inception of clinical teratology, the vast majority of scientific work has focused on identification of drugs and environmental agents causing malformations in humans as a dichotomous variable (i.e. yes or no), as well as the relative and absolute risks of such occurrences. Generally, the dose dependency of such events has not been investigated. With the establishment of large pregnancy databases, dose-dependence relationships are being uncovered for increasing numbers of medications, including valproic acid, carbamazepine, phenobarbital, lamotrigine, topiramate, and lithium. In this review we discuss new...
Source: Pediatric Drugs - August 1, 2018 Category: Pediatrics Source Type: research

Methadone for Pain Management in Children with Cancer
AbstractMethadone is a synthetic opioid with unique pharmacodynamic and pharmacokinetic properties. It is effective in treating both nociceptive and neuropathic pain, which commonly co-exist in children with cancer. Upon reviewing the literature describing the use of methadone in pediatric oncology patients, publications are limited in number and low in quality of evidence; nevertheless, there is support for the safety and efficacy of methadone in treating pain in children with cancer, particularly when pain is refractory to conventional treatment. Although the risk of life-threatening arrhythmia is commonly cited as an ar...
Source: Pediatric Drugs - July 26, 2018 Category: Pediatrics Source Type: research

Trends in Outpatient Prescription Medicine Use in New Zealand Children 2010 –2015: A National Population-Based Study
AbstractBackgroundResearch examining trends in the outpatient prescription medicine use of New Zealand children is limited.ObjectivesOur objective was to provide an overview of prescription medicine use in New Zealand children and assess changing patterns in use from 2010 to 2015.MethodsWe conducted a retrospective cohort study including all New Zealand primary care-registered children aged
Source: Pediatric Drugs - July 25, 2018 Category: Pediatrics Source Type: research

Pharmacokinetics and Drug Interaction of Antiepileptic Drugs in Children and Adolescents
AbstractSelecting the most appropriate antiepileptic drug (AED) or combination of drugs for each patient and identifying the most suitable therapeutic regimen for their needs is increasingly challenging, especially among pediatric populations. In fact, the pharmacokinetics of several drugs vary widely in children with epilepsy because of age-related factors, which can influence the absorption, distribution, metabolism, and elimination of the pharmacological agent. In addition, individual factors, such as seizure type, associated comorbidities, individual pharmacokinetics, and potential drug interactions, may contribute to ...
Source: Pediatric Drugs - July 12, 2018 Category: Pediatrics Source Type: research

Current Challenges in Neonatal Resuscitation: What is the Role of Adrenaline?
AbstractAdrenaline, also known as epinephrine, is a hormone, neurotransmitter, and medication. It is the best established drug in neonatal resuscitation, but only weak evidence supports current recommendations for its use. Furthermore, the available evidence is partly based on extrapolations from adult studies, and this introduces further uncertainty, especially when considering the unique physiological characteristics of newly born infants. The timing, dose, and route of administration of adrenaline are still debated, even though this medication has been used in neonatal resuscitation for a long time. According to the mos...
Source: Pediatric Drugs - June 19, 2018 Category: Pediatrics Source Type: research

Pediatric Cancer Immunotherapy: Opportunities and Challenges
AbstractCancer immunotherapies, widely heralded as transformational for many adult cancer patients, are becoming viable options for selected subsets of pediatric cancer patients. Many therapies are currently being investigated, from immunomodulatory agents to adoptive cell therapy, bispecific T-cell engagers, oncolytic virotherapy, and checkpoint inhibition. One of the most exciting immunotherapies recently FDA approved is the use of CD19 chimeric antigen receptor T cells for pre-B-cell acute lymphoblastic leukemia. With this approval and others, immunotherapy for pediatric cancers is gaining traction. One of the caveats t...
Source: Pediatric Drugs - June 12, 2018 Category: Pediatrics Source Type: research